Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors

Raj M Ratwani; Rollin J Fairbanks; A Zachary Hettinger; Natalie C Benda

doi:10.1093/jamia/ocv050

Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors

J Am Med Inform Assoc. 2015 Nov;22(6):1179-82. doi: 10.1093/jamia/ocv050. Epub 2015 Jun 6.

Authors

Raj M Ratwani¹, Rollin J Fairbanks², A Zachary Hettinger³, Natalie C Benda⁴

Affiliations

¹ National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA raj.ratwani@medicalhfe.org.
² National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA Department of Industrial and Systems Engineering, State University of New York at Buffalo, Buffalo, New York, USA.
³ National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA.
⁴ National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Industrial and Systems Engineering, State University of New York at Buffalo, Buffalo, New York, USA.

PMID: 26049532
DOI: 10.1093/jamia/ocv050

Abstract

The usability of electronic health records (EHRs) continues to be a point of dissatisfaction for providers, despite certification requirements from the Office of the National Coordinator that require EHR vendors to employ a user-centered design (UCD) process. To better understand factors that contribute to poor usability, a research team visited 11 different EHR vendors in order to analyze their UCD processes and discover the specific challenges that vendors faced as they sought to integrate UCD with their EHR development. Our analysis demonstrates a diverse range of vendors' UCD practices that fall into 3 categories: well-developed UCD, basic UCD, and misconceptions of UCD. Specific challenges to practicing UCD include conducting contextually rich studies of clinical workflow, recruiting participants for usability studies, and having support from leadership within the vendor organization. The results of the study provide novel insights for how to improve usability practices of EHR vendors.

Keywords: electronic health records; health information technology; human factors; usability.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Attitude to Computers
Commerce*
Electronic Health Records* / standards
Ergonomics*
Humans
Interviews as Topic
User-Computer Interface*